Price Transparencybeta Hospital negotiated rates

Hospital facility prices. What the hospital charges for the facility side of care — the surgeon’s and anesthesiologist’s fees are billed separately and are not included. How we scope prices →

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Hospital

LANGLADE HOSPITAL

Antigo, WI · CCN 521350 · Rates published

342 distinct procedures filed
20 distinct payers
46,340 rate rows
2025-07-01 last MRF observed · ⚠ 12 mo old
Data quality

3,653 of 46,340 rate rows are consumer-grade (7.9%)

42,687 rows are marked excluded from the consumer medians — these stay visible in the raw drill-down with the same reason shown here, so nothing is silently hidden.

Excluded — reasonRows
professional (physician) fee — not the facility price 27,964
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 14,723

⚠ Possibly outdated The most recent machine-readable file we have for this hospital is 12 months old. CMS requires hospitals to refresh these files at least annually, so newer rates may exist that we haven't ingested yet. The prices below are exactly as last filed.

Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://www.aspirus.org/Uploads/Public/Documents/PriceEstimate/TransparencyFY26/390806429_aspirus-langlade-hospital_standardcharges.json
Found on page https://www.aspirus.org/price-estimate
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-05-16
Content fingerprint f4e538af4d13e5f5… · 153,520,320 bytes · first seen 2026-05-09

Top 50 most expensive offerings

Outliers are flagged where this hospital's filed rate is ≥2× or ≤0.5× the national median for the same code.

Code Description Payers Min $ Max $ Avg median vs national
9284
OTHER 		Ipilimumab Injection 2 $90,881.46 $102,374.97 $96,628.21 nat. median
$188
outlier · 515.4×
9287
OTHER 		Brentuximab Vedotin Inj 1 $66,435.22 $66,435.22 $66,435.22 nat. median
$268
outlier · 247.5×
653
MS_DRG 		Major Bladder Procedures With Mcc 1 $53,345.97 $53,345.97 $53,345.97 nat. median
$51,418
1.0× median
9347
OTHER 		Inj Luspatercept-aamt 0.25mg 1 $52,950.72 $52,950.72 $52,950.72 nat. median
$43
outlier · 1218.4×
560
MS_DRG 		Aftercare, Musculoskeletal System And Connective Tissue With Cc 5 $5,007.64 $88,534.27 $46,770.96 nat. median
$12,148
outlier · 3.9×
100
MS_DRG 		Seizures With Mcc 1 $45,828.64 $45,828.64 $45,828.64 nat. median
$19,360
outlier · 2.4×
56
MS_DRG 		Degenerative Nervous System Disorders With Mcc 1 $45,803.32 $45,803.32 $45,803.32 nat. median
$22,361
outlier · 2.0×
469
MS_DRG 		Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity With Mcc… 1 $44,260.60 $44,260.60 $44,260.60 nat. median
$31,075
1.4× median
372
MS_DRG 		Major Gastrointestinal Disorders And Peritoneal Infections With Cc 1 $43,401.69 $43,401.69 $43,401.69 nat. median
$11,087
outlier · 3.9×
9057
OTHER 		Inj Nivol Relatlimab 3mg/1mg 1 $42,914.40 $42,914.40 $42,914.40 nat. median
$202
outlier · 212.7×
9494
OTHER 		Injection, Ocrelizumab 2 $30,655.48 $47,979.22 $39,317.35 nat. median
$61
outlier · 643.5×
854
MS_DRG 		Infectious And Parasitic Diseases With O.r. Procedures With Cc 5 $12,535.13 $62,536.47 $37,535.80 nat. median
$20,421
1.8× median
329
MS_DRG 		Major Small And Large Bowel Procedures With Mcc 3 $14,712.32 $59,518.69 $37,115.50 nat. median
$44,810
0.8× median
9236
OTHER 		Eculizumab Injection 1 $34,253.23 $34,253.23 $34,253.23 nat. median
$231
outlier · 148.4×
949
MS_DRG 		Aftercare With Cc/Mcc 1 $33,503.21 $33,503.21 $33,503.21 nat. median
$12,475
outlier · 2.7×
808
MS_DRG 		Major Hematological And Immunological Diagnoses Except Sickle Cell Crisis And Co… 1 $32,843.79 $32,843.79 $32,843.79 nat. median
$22,208
1.5× median
468
MS_DRG 		Revision Of Hip Or Knee Replacement Without Cc/Mcc 1 $32,277.60 $32,277.60 $32,277.60 nat. median
$27,218
1.2× median
371
MS_DRG 		Major Gastrointestinal Disorders And Peritoneal Infections With Mcc 1 $31,826.67 $31,826.67 $31,826.67 nat. median
$17,807
1.8× median
391
MS_DRG 		Esophagitis, Gastroenteritis And Miscellaneous Digestive Disorders With Mcc 1 $30,686.58 $30,686.58 $30,686.58 nat. median
$13,245
outlier · 2.3×
385
MS_DRG 		Inflammatory Bowel Disease With Mcc 1 $30,508.01 $30,508.01 $30,508.01 nat. median
$16,227
1.9× median
553
MS_DRG 		Bone Diseases And Arthropathies With Mcc 1 $29,952.85 $29,952.85 $29,952.85 nat. median
$13,586
outlier · 2.2×
522
MS_DRG 		Hip Replacement With Principal Diagnosis Of Hip Fracture Without Mcc 1 $29,765.53 $29,765.53 $29,765.53 nat. median
$21,760
1.4× median
724
MS_DRG 		Malignancy, Male Reproductive System Without Cc/Mcc 1 $29,630.73 $29,630.73 $29,630.73 nat. median
$8,019
outlier · 3.7×
330
MS_DRG 		Major Small And Large Bowel Procedures With Cc 6 $11,497.63 $44,842.23 $28,169.93 nat. median
$24,346
1.2× median
399
MS_DRG 		Appendix Procedures Without Cc/Mcc 3 $6,987.59 $47,808.40 $27,397.99 nat. median
$12,332
outlier · 2.2×
871
MS_DRG 		Septicemia Or Severe Sepsis Without Mv >96 Hours With Mcc 9 $4,550.58 $50,036.62 $27,293.60 nat. median
$19,634
1.4× median
564
MS_DRG 		Other Musculoskeletal System And Connective Tissue Diagnoses With Mcc 4 $2,781.96 $50,998.36 $26,890.16 nat. median
$15,782
1.7× median
870
MS_DRG 		Septicemia Or Severe Sepsis With Mv >96 Hours 2 $17,266.65 $36,311.78 $26,789.22 nat. median
$66,526
outlier · 0.4×
561
MS_DRG 		Aftercare, Musculoskeletal System And Connective Tissue Without Cc/Mcc 2 $9,765.94 $43,346.31 $26,556.12 nat. median
$9,193
outlier · 2.9×
563
MS_DRG 		Fracture, Sprain, Strain And Dislocation Except Femur, Hip, Pelvis And Thigh Wit… 2 $22,325.87 $30,397.01 $26,361.44 nat. median
$9,671
outlier · 2.7×
637
MS_DRG 		Diabetes With Mcc 2 $6,251.24 $45,081.02 $25,666.13 nat. median
$14,787
1.7× median
948
MS_DRG 		Signs And Symptoms Without Mcc 2 $6,523.57 $44,654.27 $25,588.92 nat. median
$8,515
outlier · 3.0×
193
MS_DRG 		Simple Pneumonia And Pleurisy With Mcc 7 $10,251.45 $40,735.15 $25,493.30 nat. median
$13,648
1.9× median
98
MS_DRG 		Non-bacterial Infection Of Nervous System Except Viral Meningitis With Cc 1 $25,417.61 $25,417.61 $25,417.61 nat. median
$22,276
1.1× median
864
MS_DRG 		Fever And Inflammatory Conditions 1 $25,128.80 $25,128.80 $25,128.80 nat. median
$9,803
outlier · 2.6×
9453
OTHER 		Injection, Nivolumab 3 $12,754.98 $37,370.26 $25,062.62 nat. median
$34
outlier · 742.8×
9492
OTHER 		Inj., Durvalumab, 10 Mg 3 $11,170.18 $38,156.08 $24,663.13 nat. median
$87
outlier · 284.4×
947
MS_DRG 		Signs And Symptoms With Mcc 2 $19,549.20 $29,153.58 $24,351.39 nat. median
$12,688
1.9× median
884
MS_DRG 		Organic Disturbances And Intellectual Disability 1 $24,312.70 $24,312.70 $24,312.70 nat. median
$14,858
1.6× median
607
MS_DRG 		Minor Skin Disorders Without Mcc 1 $23,819.47 $23,819.47 $23,819.47 nat. median
$9,674
outlier · 2.5×
331
MS_DRG 		Major Small And Large Bowel Procedures Without Cc/Mcc 1 $8,759.53 $38,229.79 $23,494.66 nat. median
$17,703
1.3× median
956
MS_DRG 		Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma 1 $22,683.81 $22,683.81 $22,683.81 nat. median
$37,662
0.6× median
554
MS_DRG 		Bone Diseases And Arthropathies Without Mcc 1 $22,386.86 $22,386.86 $22,386.86 nat. median
$9,260
outlier · 2.4×
482
MS_DRG 		Hip And Femur Procedures Except Major Joint Without Cc/Mcc 1 $22,343.85 $22,343.85 $22,343.85 nat. median
$17,025
1.3× median
640
MS_DRG 		Miscellaneous Disorders Of Nutrition, Metabolism, Fluids And Electrolytes With M… 7 $2,952.37 $41,564.55 $22,258.46 nat. median
$13,400
1.7× median
556
MS_DRG 		Signs And Symptoms Of Musculoskeletal System And Connective Tissue Without Mcc 1 $21,942.61 $21,942.61 $21,942.61 nat. median
$9,145
outlier · 2.4×
682
MS_DRG 		Renal Failure With Mcc 4 $6,386.50 $36,169.90 $21,278.20 nat. median
$15,223
1.4× median
312
MS_DRG 		Syncope And Collapse 3 $7,113.02 $35,325.10 $21,219.06 nat. median
$9,478
outlier · 2.2×
435
MS_DRG 		Malignancy Of Hepatobiliary System Or Pancreas With Mcc 1 $21,130.79 $21,130.79 $21,130.79 nat. median
$18,498
1.1× median
897
MS_DRG 		Alcohol, Drug Abuse Or Dependence Without Rehabilitation Therapy Without Mcc 3 $3,189.41 $38,778.38 $20,983.90 nat. median
$8,726
outlier · 2.4×

Other procedures at this hospital

Browse this hospital's 342 published procedures. Use the slice to choose what to show, then sort or filter any column.

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Sortable, filterable data table. Use the column headers to sort, the filter row to narrow results.
Code Type Description Rate rows Payers Gross Cash Min $ Max $ Avg median Last observed
             
9284 OTHER Ipilimumab Injection 4 2 — — $90,881.46 $102,374.97 $96,628.21 2025-07-01
9287 OTHER Brentuximab Vedotin Inj 2 1 — — $66,435.22 $66,435.22 $66,435.22 2025-07-01
653 MS_DRG Major Bladder Procedures With Mcc 2 1 — — $53,345.97 $53,345.97 $53,345.97 2025-07-01
9347 OTHER Inj Luspatercept-aamt 0.25mg 2 1 — — $52,950.72 $52,950.72 $52,950.72 2025-07-01
560 MS_DRG Aftercare, Musculoskeletal System And Connective Tissue With Cc 14 5 — — $5,007.64 $88,534.27 $46,770.96 2025-07-01
100 MS_DRG Seizures With Mcc 2 1 — — $45,828.64 $45,828.64 $45,828.64 2025-07-01
56 MS_DRG Degenerative Nervous System Disorders With Mcc 2 1 — — $45,803.32 $45,803.32 $45,803.32 2025-07-01
469 MS_DRG Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity With Mcc… 2 1 — — $44,260.60 $44,260.60 $44,260.60 2025-07-01
372 MS_DRG Major Gastrointestinal Disorders And Peritoneal Infections With Cc 2 1 — — $43,401.69 $43,401.69 $43,401.69 2025-07-01
9057 OTHER Inj Nivol Relatlimab 3mg/1mg 2 1 — — $42,914.40 $42,914.40 $42,914.40 2025-07-01
9494 OTHER Injection, Ocrelizumab 4 2 — — $30,655.48 $47,979.22 $39,317.35 2025-07-01
854 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Cc 12 5 — — $12,535.13 $62,536.47 $37,535.80 2025-07-01
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 6 3 — — $14,712.32 $59,518.69 $37,115.50 2025-07-01
9236 OTHER Eculizumab Injection 2 1 — — $34,253.23 $34,253.23 $34,253.23 2025-07-01
949 MS_DRG Aftercare With Cc/Mcc 2 1 — — $33,503.21 $33,503.21 $33,503.21 2025-07-01
808 MS_DRG Major Hematological And Immunological Diagnoses Except Sickle Cell Crisis And Co… 2 1 — — $32,843.79 $32,843.79 $32,843.79 2025-07-01
468 MS_DRG Revision Of Hip Or Knee Replacement Without Cc/Mcc 2 1 — — $32,277.60 $32,277.60 $32,277.60 2025-07-01
371 MS_DRG Major Gastrointestinal Disorders And Peritoneal Infections With Mcc 2 1 — — $31,826.67 $31,826.67 $31,826.67 2025-07-01
391 MS_DRG Esophagitis, Gastroenteritis And Miscellaneous Digestive Disorders With Mcc 2 1 — — $30,686.58 $30,686.58 $30,686.58 2025-07-01
385 MS_DRG Inflammatory Bowel Disease With Mcc 2 1 — — $30,508.01 $30,508.01 $30,508.01 2025-07-01
553 MS_DRG Bone Diseases And Arthropathies With Mcc 2 1 — — $29,952.85 $29,952.85 $29,952.85 2025-07-01
522 MS_DRG Hip Replacement With Principal Diagnosis Of Hip Fracture Without Mcc 2 1 — — $29,765.53 $29,765.53 $29,765.53 2025-07-01
724 MS_DRG Malignancy, Male Reproductive System Without Cc/Mcc 2 1 — — $29,630.73 $29,630.73 $29,630.73 2025-07-01
330 MS_DRG Major Small And Large Bowel Procedures With Cc 12 6 — — $11,497.63 $44,842.23 $28,169.93 2025-07-01
399 MS_DRG Appendix Procedures Without Cc/Mcc 6 3 — — $6,987.59 $47,808.40 $27,397.99 2025-07-01
871 MS_DRG Septicemia Or Severe Sepsis Without Mv >96 Hours With Mcc 34 9 — — $4,550.58 $50,036.62 $27,293.60 2025-07-01
564 MS_DRG Other Musculoskeletal System And Connective Tissue Diagnoses With Mcc 12 4 — — $2,781.96 $50,998.36 $26,890.16 2025-07-01
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 4 2 — — $17,266.65 $36,311.78 $26,789.22 2025-07-01
561 MS_DRG Aftercare, Musculoskeletal System And Connective Tissue Without Cc/Mcc 4 2 — — $9,765.94 $43,346.31 $26,556.12 2025-07-01
563 MS_DRG Fracture, Sprain, Strain And Dislocation Except Femur, Hip, Pelvis And Thigh Wit… 4 2 — — $22,325.87 $30,397.01 $26,361.44 2025-07-01
637 MS_DRG Diabetes With Mcc 4 2 — — $6,251.24 $45,081.02 $25,666.13 2025-07-01
948 MS_DRG Signs And Symptoms Without Mcc 4 2 — — $6,523.57 $44,654.27 $25,588.92 2025-07-01
193 MS_DRG Simple Pneumonia And Pleurisy With Mcc 24 7 — — $10,251.45 $40,735.15 $25,493.30 2025-07-01
98 MS_DRG Non-bacterial Infection Of Nervous System Except Viral Meningitis With Cc 2 1 — — $25,417.61 $25,417.61 $25,417.61 2025-07-01
864 MS_DRG Fever And Inflammatory Conditions 2 1 — — $25,128.80 $25,128.80 $25,128.80 2025-07-01
9453 OTHER Injection, Nivolumab 8 3 — — $12,754.98 $37,370.26 $25,062.62 2025-07-01
9492 OTHER Inj., Durvalumab, 10 Mg 8 3 — — $11,170.18 $38,156.08 $24,663.13 2025-07-01
947 MS_DRG Signs And Symptoms With Mcc 4 2 — — $19,549.20 $29,153.58 $24,351.39 2025-07-01
884 MS_DRG Organic Disturbances And Intellectual Disability 2 1 — — $24,312.70 $24,312.70 $24,312.70 2025-07-01
607 MS_DRG Minor Skin Disorders Without Mcc 2 1 — — $23,819.47 $23,819.47 $23,819.47 2025-07-01
331 MS_DRG Major Small And Large Bowel Procedures Without Cc/Mcc 4 1 — — $8,759.53 $38,229.79 $23,494.66 2025-07-01
956 MS_DRG Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma 2 1 — — $22,683.81 $22,683.81 $22,683.81 2025-07-01
554 MS_DRG Bone Diseases And Arthropathies Without Mcc 2 1 — — $22,386.86 $22,386.86 $22,386.86 2025-07-01
482 MS_DRG Hip And Femur Procedures Except Major Joint Without Cc/Mcc 2 1 — — $22,343.85 $22,343.85 $22,343.85 2025-07-01
640 MS_DRG Miscellaneous Disorders Of Nutrition, Metabolism, Fluids And Electrolytes With M… 20 7 — — $2,952.37 $41,564.55 $22,258.46 2025-07-01
556 MS_DRG Signs And Symptoms Of Musculoskeletal System And Connective Tissue Without Mcc 2 1 — — $21,942.61 $21,942.61 $21,942.61 2025-07-01
682 MS_DRG Renal Failure With Mcc 14 4 — — $6,386.50 $36,169.90 $21,278.20 2025-07-01
312 MS_DRG Syncope And Collapse 8 3 — — $7,113.02 $35,325.10 $21,219.06 2025-07-01
435 MS_DRG Malignancy Of Hepatobiliary System Or Pancreas With Mcc 2 1 — — $21,130.79 $21,130.79 $21,130.79 2025-07-01
897 MS_DRG Alcohol, Drug Abuse Or Dependence Without Rehabilitation Therapy Without Mcc 6 3 — — $3,189.41 $38,778.38 $20,983.90 2025-07-01
394 MS_DRG Other Digestive System Diagnoses With Cc 6 3 — — $12,418.89 $29,506.89 $20,962.89 2025-07-01
562 MS_DRG Fracture, Sprain, Strain And Dislocation Except Femur, Hip, Pelvis And Thigh Wit… 4 2 — — $14,400.15 $26,440.30 $20,420.22 2025-07-01
418 MS_DRG Laparoscopic Cholecystectomy Without C.d.e. With Cc 4 2 — — $12,400.62 $28,412.23 $20,406.42 2025-07-01
1490 OTHER Inj Pembrolizumab 22 6 — — $9,531.33 $31,240.91 $20,386.12 2025-07-01
551 MS_DRG Medical Back Problems With Mcc 4 2 — — $17,058.11 $22,977.44 $20,017.78 2025-07-01
9276 OTHER Cabazitaxel Injection 2 1 — — $19,890.38 $19,890.38 $19,890.38 2025-07-01
417 MS_DRG Laparoscopic Cholecystectomy Without C.d.e. With Mcc 4 2 — — $15,673.51 $24,039.26 $19,856.38 2025-07-01
552 MS_DRG Medical Back Problems Without Mcc 8 3 — — $3,189.41 $36,192.58 $19,690.99 2025-07-01
9353 OTHER Inj Fam-trastu Deru-nxki 1mg 2 1 — — $19,573.64 $19,573.64 $19,573.64 2025-07-01
378 MS_DRG Gastrointestinal Hemorrhage With Cc 14 4 — — $6,378.82 $32,739.44 $19,559.13 2025-07-01
5626 OTHER Level 6 Radiation Therapy 8 4 — — $8,433.32 $30,564.56 $19,498.94 2025-07-01
786 MS_DRG Cesarean Section Without Sterilization With Mcc 2 1 — — $19,420.95 $19,420.95 $19,420.95 2025-07-01
639 MS_DRG Diabetes Without Cc/Mcc 4 2 — — $7,720.23 $30,978.89 $19,349.56 2025-07-01
313 MS_DRG Chest Pain 2 1 — — $19,330.95 $19,330.95 $19,330.95 2025-07-01
5613 OTHER Level 3 Therapeutic Radiation Treatment Preparation 12 4 — — $7,180.78 $31,361.28 $19,271.03 2025-07-01
1488 OTHER Injection, Ramucirumab 4 2 — — $17,516.54 $20,959.42 $19,237.98 2025-07-01
189 MS_DRG Pulmonary Edema And Respiratory Failure 16 6 — — $6,378.82 $31,346.26 $18,862.54 2025-07-01
283 MS_DRG Acute Myocardial Infarction, Expired With Mcc 4 2 — — $16,680.42 $21,033.09 $18,856.76 2025-07-01
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 2 1 — — $18,495.26 $18,495.26 $18,495.26 2025-07-01
788 MS_DRG Cesarean Section Without Sterilization Without Cc/Mcc 14 6 — — $12,535.13 $24,438.31 $18,486.72 2025-07-01
139 MS_DRG Salivary Gland Procedures 6 3 — — $10,251.56 $26,146.97 $18,199.26 2025-07-01
208 MS_DRG Respiratory System Diagnosis With Ventilator Support <=96 Hours 4 2 — — $8,004.80 $28,189.45 $18,097.12 2025-07-01
374 MS_DRG Digestive Malignancy With Mcc 4 2 — — $12,047.40 $23,797.90 $17,922.65 2025-07-01
180 MS_DRG Respiratory Neoplasms With Mcc 4 1 — — $13,250.01 $22,341.23 $17,795.62 2025-07-01
73 MS_DRG Cranial And Peripheral Nerve Disorders With Mcc 4 2 — — $15,565.43 $20,017.04 $17,791.24 2025-07-01
812 MS_DRG Red Blood Cell Disorders Without Mcc 6 2 — — $7,278.53 $28,045.44 $17,661.99 2025-07-01
644 MS_DRG Endocrine Disorders With Cc 4 2 — — $12,757.64 $22,338.37 $17,548.01 2025-07-01
543 MS_DRG Pathological Fractures And Musculoskeletal And Connective Tissue Malignancy With… 2 1 — — $16,796.83 $16,796.83 $16,796.83 2025-07-01
559 MS_DRG Aftercare, Musculoskeletal System And Connective Tissue With Mcc 2 1 — — $16,685.76 $16,685.76 $16,685.76 2025-07-01
5623 OTHER Level 3 Radiation Therapy 19 11 — — $945.10 $102,912.87 $16,619.88 2025-07-01
389 MS_DRG Gastrointestinal Obstruction With Cc 8 3 — — $10,959.40 $22,164.35 $16,561.88 2025-07-01
183 MS_DRG Major Chest Trauma With Mcc 2 1 — — $16,510.24 $16,510.24 $16,510.24 2025-07-01
841 MS_DRG Lymphoma And Non-acute Leukemia With Cc 2 1 — — $16,402.74 $16,402.74 $16,402.74 2025-07-01
178 MS_DRG Respiratory Infections And Inflammations With Cc 6 3 — — $12,247.67 $20,516.09 $16,381.88 2025-07-01
282 MS_DRG Acute Myocardial Infarction, Discharged Alive Without Cc/Mcc 8 3 — — $2,531.30 $29,932.46 $16,231.88 2025-07-01
638 MS_DRG Diabetes With Cc 10 5 — — $10,438.14 $21,936.68 $16,187.41 2025-07-01
181 MS_DRG Respiratory Neoplasms With Cc 2 1 — — $15,957.02 $15,957.02 $15,957.02 2025-07-01
133 MS_DRG Other Ear, Nose, Mouth & Throat O.r. Procedures W Cc/Mcc 2 1 — — $15,839.90 $15,839.90 $15,839.90 2025-07-01
202 MS_DRG Bronchitis And Asthma With Cc/Mcc 4 2 — — $13,978.45 $17,605.28 $15,791.86 2025-07-01
481 MS_DRG Hip And Femur Procedures Except Major Joint With Cc 4 2 — — $13,580.52 $17,577.71 $15,579.11 2025-07-01
83 MS_DRG Traumatic Stupor And Coma >1 Hour With Cc 2 1 — — $15,460.82 $15,460.82 $15,460.82 2025-07-01
445 MS_DRG Disorders Of The Biliary Tract With Cc 4 2 — — $10,201.41 $20,635.93 $15,418.67 2025-07-01
689 MS_DRG Kidney And Urinary Tract Infections With Mcc 4 2 — — $3,798.61 $26,850.64 $15,324.62 2025-07-01
787 MS_DRG Cesarean Section Without Sterilization With Cc 8 4 — — $6,283.88 $24,222.77 $15,253.33 2025-07-01
308 MS_DRG Cardiac Arrhythmia And Conduction Disorders With Mcc 8 4 — — $8,286.11 $22,038.53 $15,162.32 2025-07-01
540 MS_DRG Osteomyelitis With Cc 8 4 — — $13,575.78 $16,205.61 $14,890.69 2025-07-01
958 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Cc 2 1 — — $14,873.51 $14,873.51 $14,873.51 2025-07-01
194 MS_DRG Simple Pneumonia And Pleurisy With Cc 8 4 — — $7,178.77 $22,433.93 $14,806.35 2025-07-01
480 MS_DRG Hip And Femur Procedures Except Major Joint With Mcc 2 1 — — $14,711.60 $14,711.60 $14,711.60 2025-07-01
291 MS_DRG Heart Failure And Shock With Mcc 26 7 — — $8,278.41 $21,108.75 $14,693.58 2025-07-01
1207 OTHER Octreotide Injection, Depot 4 2 — — $8,598.51 $20,136.06 $14,367.28 2025-07-01
9474 OTHER Inj Irinotecan Liposome 1 Mg 2 1 — — $14,340.79 $14,340.79 $14,340.79 2025-07-01
1476 OTHER Obinutuzumab Inj 2 1 — — $14,254.30 $14,254.30 $14,254.30 2025-07-01
381 MS_DRG Complicated Peptic Ulcer With Cc 2 1 — — $14,132.03 $14,132.03 $14,132.03 2025-07-01
175 MS_DRG Pulmonary Embolism With Mcc Or Acute Cor Pulmonale 2 1 — — $14,082.42 $14,082.42 $14,082.42 2025-07-01
592 MS_DRG Skin Ulcers With Mcc 2 1 — — $14,040.35 $14,040.35 $14,040.35 2025-07-01
419 MS_DRG Laparoscopic Cholecystectomy Without C.d.e. Without Cc/Mcc 4 2 — — $8,303.34 $19,692.03 $13,997.68 2025-07-01
5114 OTHER Level 4 Musculoskeletal Procedures 2 1 — — $13,975.82 $13,975.82 $13,975.82 2025-07-01
441 MS_DRG Disorders Of Liver Except Malignancy, Cirrhosis Or Alcoholic Hepatitis With Mcc 2 1 — — $13,943.67 $13,943.67 $13,943.67 2025-07-01
386 MS_DRG Inflammatory Bowel Disease With Cc 8 3 — — $6,804.67 $21,064.53 $13,934.60 2025-07-01
690 MS_DRG Kidney And Urinary Tract Infections Without Mcc 8 3 — — $6,378.82 $21,080.46 $13,729.64 2025-07-01
48 MS_DRG Other Disorders Of The Eye Age 0-17 2 1 — — $13,655.77 $13,655.77 $13,655.77 2025-07-01
138 MS_DRG Mouth Procedures Without Cc/Mcc 2 1 — — $13,556.67 $13,556.67 $13,556.67 2025-07-01
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 2 1 — — $13,538.30 $13,538.30 $13,538.30 2025-07-01
9235 OTHER Panitumumab Injection 6 3 — — $5,354.15 $21,668.27 $13,511.21 2025-07-01
9378 OTHER Daratumumab, Hyaluronidase 4 2 — — $8,601.89 $18,257.76 $13,429.83 2025-07-01
683 MS_DRG Renal Failure With Cc 14 5 — — $6,595.40 $20,121.53 $13,358.47 2025-07-01
280 MS_DRG Acute Myocardial Infarction, Discharged Alive With Mcc 18 6 — — $2,315.30 $24,338.99 $13,327.15 2025-07-01
420 MS_DRG Hepatobiliary Diagnostic Procedures With Mcc 2 1 — — $13,311.07 $13,311.07 $13,311.07 2025-07-01
442 MS_DRG Disorders Of Liver Except Malignancy, Cirrhosis Or Alcoholic Hepatitis With Cc 4 2 — — $2,719.80 $23,709.71 $13,214.75 2025-07-01
439 MS_DRG Disorders Of Pancreas Except Malignancy With Cc 4 2 — — $12,535.13 $13,856.29 $13,195.71 2025-07-01
641 MS_DRG Miscellaneous Disorders Of Nutrition, Metabolism, Fluids And Electrolytes Withou… 12 4 — — $3,271.37 $22,984.51 $13,127.94 2025-07-01
351 MS_DRG Inguinal And Femoral Hernia Procedures With Cc 2 1 — — $13,060.04 $13,060.04 $13,060.04 2025-07-01
1471 OTHER Injection, Pertuzumab, 1 Mg 2 1 — — $13,049.68 $13,049.68 $13,049.68 2025-07-01
919 MS_DRG Complications Of Treatment With Mcc 2 1 — — $13,012.80 $13,012.80 $13,012.80 2025-07-01
244 MS_DRG Permanent Cardiac Pacemaker Implant Without Cc/Mcc 2 1 — — $13,008.93 $13,008.93 $13,008.93 2025-07-01
805 MS_DRG Vaginal Delivery Without Sterilization Or D&c With Mcc 4 2 — — $12,122.58 $13,784.87 $12,953.73 2025-07-01
9002 OTHER Tenecteplase Injection 18 6 — — $1,546.56 $24,345.24 $12,945.90 2025-07-01
52 MS_DRG Spinal Disorders And Injuries With Cc/Mcc 2 1 — — $12,892.36 $12,892.36 $12,892.36 2025-07-01
190 MS_DRG Chronic Obstructive Pulmonary Disease With Mcc 2 1 — — $12,891.63 $12,891.63 $12,891.63 2025-07-01
388 MS_DRG Gastrointestinal Obstruction With Mcc 6 3 — — $10,181.10 $15,519.95 $12,850.52 2025-07-01
565 MS_DRG Other Musculoskeletal System And Connective Tissue Diagnoses With Cc 6 2 — — $7,394.09 $18,232.52 $12,813.31 2025-07-01
602 MS_DRG Cellulitis With Mcc 2 1 — — $12,757.64 $12,757.64 $12,757.64 2025-07-01
9215 OTHER Cetuximab Injection 4 2 — — $9,189.27 $15,829.78 $12,509.52 2025-07-01
643 MS_DRG Endocrine Disorders With Mcc 2 1 — — $12,358.27 $12,358.27 $12,358.27 2025-07-01
398 MS_DRG Appendix Procedures With Cc 2 1 — — $12,296.12 $12,296.12 $12,296.12 2025-07-01
775 MS_DRG Vaginal Delivery Without Complicating Diagnoses 6 3 — — $9,160.11 $15,361.14 $12,260.62 2025-07-01
603 MS_DRG Cellulitis Without Mcc 14 4 — — $4,027.34 $20,436.12 $12,231.73 2025-07-01
9389 OTHER Inj. Lurbinectedin, 0.1 Mg 2 1 — — $12,184.83 $12,184.83 $12,184.83 2025-07-01
177 MS_DRG Respiratory Infections And Inflammations With Mcc 18 6 — — $5,014.93 $19,323.94 $12,169.43 2025-07-01
281 MS_DRG Acute Myocardial Infarction, Discharged Alive With Cc 4 2 — — $9,648.75 $14,551.92 $12,100.33 2025-07-01
917 MS_DRG Poisoning And Toxic Effects Of Drugs With Mcc 4 1 — — $9,568.23 $14,099.93 $11,834.08 2025-07-01
521 MS_DRG Hip Replacement With Principal Diagnosis Of Hip Fracture With Mcc 2 1 — — $11,720.31 $11,720.31 $11,720.31 2025-07-01
240 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Cc 2 1 — — $11,430.33 $11,430.33 $11,430.33 2025-07-01
245 MS_DRG Aicd Generator Procedures 2 1 — — $11,325.08 $11,325.08 $11,325.08 2025-07-01
5801 OTHER Ventilation Initiation And Management 2 1 — — $11,314.72 $11,314.72 $11,314.72 2025-07-01
310 MS_DRG Cardiac Arrhythmia And Conduction Disorders Without Cc/Mcc 8 4 — — $1,900.79 $20,688.00 $11,294.40 2025-07-01
9483 OTHER Inj, Atezolizumab,10 Mg 6 3 — — $9,447.04 $13,132.74 $11,289.89 2025-07-01
201 MS_DRG Pneumothorax Without Cc/Mcc 6 2 — — $6,953.93 $15,242.55 $11,098.24 2025-07-01
698 MS_DRG Other Kidney And Urinary Tract Diagnoses With Mcc 6 2 — — $6,861.22 $15,107.24 $10,984.23 2025-07-01
200 MS_DRG Pneumothorax With Cc 4 1 — — $10,245.34 $11,309.30 $10,777.32 2025-07-01
393 MS_DRG Other Digestive System Diagnoses With Mcc 4 2 — — $6,230.99 $15,089.09 $10,660.04 2025-07-01
809 MS_DRG Major Hematological And Immunological Diagnoses Except Sickle Cell Crisis And Co… 2 1 — — $10,640.49 $10,640.49 $10,640.49 2025-07-01
354 MS_DRG Hernia Procedures Except Inguinal And Femoral With Cc 2 1 — — $10,557.00 $10,557.00 $10,557.00 2025-07-01
728 MS_DRG Inflammation Of The Male Reproductive System Without Mcc 4 1 — — $6,378.82 $14,573.31 $10,476.07 2025-07-01
817 MS_DRG Other Antepartum Diagnoses With O.r. Procedures With Mcc 2 1 — — $10,469.22 $10,469.22 $10,469.22 2025-07-01
103 MS_DRG Headaches Without Mcc 2 1 — — $10,419.38 $10,419.38 $10,419.38 2025-07-01
392 MS_DRG Esophagitis, Gastroenteritis And Miscellaneous Digestive Disorders Without Mcc 10 4 — — $2,825.58 $17,879.95 $10,352.76 2025-07-01
9173 OTHER Injection, Fulphila 10 5 — — $2,292.28 $18,353.80 $10,323.04 2025-07-01
9010 OTHER Inj Efgartigimod 2mg 2 1 — — $10,249.43 $10,249.43 $10,249.43 2025-07-01
346 MS_DRG Minor Small And Large Bowel Procedures Without Cc/Mcc 2 1 — — $10,113.82 $10,113.82 $10,113.82 2025-07-01
433 MS_DRG Cirrhosis And Alcoholic Hepatitis With Cc 2 1 — — $10,071.86 $10,071.86 $10,071.86 2025-07-01
907 MS_DRG Other O.r. Procedures For Injuries With Mcc 2 1 — — $10,040.01 $10,040.01 $10,040.01 2025-07-01
421 MS_DRG Hepatobiliary Diagnostic Procedures With Cc 2 1 — — $10,013.67 $10,013.67 $10,013.67 2025-07-01
9291 OTHER Inj, Clindamycin Phosp 300mg 12 4 — — $4,042.83 $15,928.54 $9,985.68 2025-07-01
872 MS_DRG Septicemia Or Severe Sepsis Without Mv >96 Hours Without Mcc 12 5 — — $1,401.75 $50,803.43 $9,978.44 2025-07-01
542 MS_DRG Pathological Fractures And Musculoskeletal And Connective Tissue Malignancy With… 2 1 — — $9,825.67 $9,825.67 $9,825.67 2025-07-01
768 MS_DRG Vaginal Delivery With O.r. Procedures Except Sterilization And/Or D&c 4 2 — — $9,278.64 $10,053.31 $9,665.98 2025-07-01
5622 OTHER Level 2 Radiation Therapy 18 6 — — $1,362.38 $17,724.34 $9,543.36 2025-07-01
71 MS_DRG Nonspecific Cerebrovascular Disorders With Cc 4 2 — — $6,441.02 $12,526.49 $9,483.75 2025-07-01
684 MS_DRG Renal Failure Without Cc/Mcc 2 1 — — $9,348.45 $9,348.45 $9,348.45 2025-07-01
176 MS_DRG Pulmonary Embolism Without Mcc 4 2 — — $5,679.84 $12,966.57 $9,323.20 2025-07-01
82 MS_DRG Traumatic Stupor And Coma >1 Hour With Mcc 2 1 — — $9,319.73 $9,319.73 $9,319.73 2025-07-01
65 MS_DRG Intracranial Hemorrhage Or Cerebral Infarction With Cc Or Tpa In 24 Hours 6 2 — — $8,355.82 $10,174.40 $9,265.11 2025-07-01
0944 OTHER Gammagard Liquid Injection 8 2 — — $5,115.68 $12,973.92 $9,044.80 2025-07-01
951 MS_DRG Other Factors Influencing Health Status 10 4 — — $3,997.96 $13,832.09 $8,915.02 2025-07-01
9290 OTHER Inj, Bupivacaine, Nos, 0.5mg 42 10 — — $2,630.91 $15,110.69 $8,870.80 2025-07-01
9132 OTHER Prothrombin Complex Kcentra 6 2 — — $6,941.13 $10,760.66 $8,850.90 2025-07-01
192 MS_DRG Chronic Obstructive Pulmonary Disease Without Cc/Mcc 2 1 — — $8,822.07 $8,822.07 $8,822.07 2025-07-01
5674 OTHER Level 4 Pathology 2 1 — — $8,821.87 $8,821.87 $8,821.87 2025-07-01
5461 OTHER Level 1 Neurostimulator And Related Procedures 2 1 — — $8,782.19 $8,782.19 $8,782.19 2025-07-01
9376 OTHER Sacituzumab Govitecan-hziy 2 1 — — $8,699.75 $8,699.75 $8,699.75 2025-07-01
149 MS_DRG Dysequilibrium 2 1 — — $8,693.70 $8,693.70 $8,693.70 2025-07-01
807 MS_DRG Vaginal Delivery Without Sterilization Or D&c Without Cc/Mcc 22 9 — — $6,177.02 $11,049.93 $8,613.48 2025-07-01
645 MS_DRG Endocrine Disorders Without Cc/Mcc 4 2 — — $4,192.62 $12,904.84 $8,548.73 2025-07-01
723 MS_DRG Malignancy, Male Reproductive System With Cc 2 1 — — $8,548.37 $8,548.37 $8,548.37 2025-07-01
390 MS_DRG Gastrointestinal Obstruction Without Cc/Mcc 6 3 — — $4,644.30 $12,120.64 $8,382.47 2025-07-01
9363 OTHER Inj, Esmolol Hcl, 10mg 8 3 — — $2,690.58 $13,881.86 $8,286.22 2025-07-01
395 MS_DRG Other Digestive System Diagnoses Without Cc/Mcc 2 1 — — $8,265.54 $8,265.54 $8,265.54 2025-07-01
536 MS_DRG Fractures Of Hip And Pelvis Without Mcc 2 1 — — $8,256.87 $8,256.87 $8,256.87 2025-07-01
1446 OTHER Visualization Adjunct 2 1 — — $8,099.99 $8,099.99 $8,099.99 2025-07-01
191 MS_DRG Chronic Obstructive Pulmonary Disease With Cc 8 4 — — $1,782.61 $14,256.78 $8,019.69 2025-07-01
309 MS_DRG Cardiac Arrhythmia And Conduction Disorders With Cc 4 2 — — $1,465.34 $14,517.86 $7,991.60 2025-07-01
5431 OTHER Level 1 Nerve Procedures 50 11 — — $870.53 $14,932.27 $7,901.40 2025-07-01
1861 OTHER Inj., Bendeka 1 Mg 6 2 — — $1,358.13 $14,370.88 $7,864.51 2025-07-01
9295 OTHER Injection, Carfilzomib, 1 Mg 2 1 — — $7,777.07 $7,777.07 $7,777.07 2025-07-01
9237 OTHER Inj, Lanreotide Acetate 2 1 — — $7,684.47 $7,684.47 $7,684.47 2025-07-01
5041 OTHER Critical Care 52 11 — — $1,390.25 $13,741.89 $7,566.07 2025-07-01
203 MS_DRG Bronchitis And Asthma Without Cc/Mcc 2 1 — — $7,479.13 $7,479.13 $7,479.13 2025-07-01
247 MS_DRG Percutaneous Cardiovascular Procedures With Drug-eluting Stent Without Mcc 2 1 — — $7,401.50 $7,401.50 $7,401.50 2025-07-01
9411 OTHER Inj. Riabni, 10 Mg 2 1 — — $7,378.80 $7,378.80 $7,378.80 2025-07-01
314 MS_DRG Other Circulatory System Diagnoses With Mcc 2 1 — — $6,983.86 $6,983.86 $6,983.86 2025-07-01
66 MS_DRG Intracranial Hemorrhage Or Cerebral Infarction Without Cc/Mcc 6 3 — — $3,167.98 $10,781.30 $6,974.64 2025-07-01
811 MS_DRG Red Blood Cell Disorders With Mcc 2 1 — — $6,919.04 $6,919.04 $6,919.04 2025-07-01
813 MS_DRG Coagulation Disorders 4 1 — — $3,835.27 $9,904.51 $6,869.89 2025-07-01
74 MS_DRG Cranial And Peripheral Nerve Disorders Without Mcc 2 1 — — $6,861.49 $6,861.49 $6,861.49 2025-07-01
9367 OTHER Inj Ruxience, 10 Mg 12 4 — — $4,132.09 $9,560.49 $6,846.29 2025-07-01
699 MS_DRG Other Kidney And Urinary Tract Diagnoses With Cc 4 2 — — $2,988.97 $10,475.06 $6,732.02 2025-07-01
806 MS_DRG Vaginal Delivery Without Sterilization Or D&c With Cc 8 4 — — $4,360.72 $9,018.64 $6,689.68 2025-07-01
69 MS_DRG Transient Ischemia Without Thrombolytic 6 3 — — $3,715.97 $9,652.71 $6,684.34 2025-07-01
64 MS_DRG Intracranial Hemorrhage Or Cerebral Infarction With Mcc 4 2 — — $3,189.41 $9,870.54 $6,529.98 2025-07-01
9341 OTHER Inj Ogivri 10 Mg 4 2 — — $5,365.65 $7,629.55 $6,497.60 2025-07-01
470 MS_DRG Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity Without … 2 1 — — $6,378.82 $6,378.82 $6,378.82 2025-07-01
558 MS_DRG Tendonitis, Myositis And Bursitis Without Mcc 2 1 — — $6,378.82 $6,378.82 $6,378.82 2025-07-01
9195 OTHER Injection, Udenyca 0.5 Mg 10 3 — — $2,403.75 $10,353.46 $6,378.60 2025-07-01
77 MS_DRG Hypertensive Encephalopathy With Mcc 2 1 — — $6,264.54 $6,264.54 $6,264.54 2025-07-01
566 MS_DRG Other Musculoskeletal System And Connective Tissue Diagnoses Without Cc/Mcc 6 2 — — $2,748.88 $9,387.80 $6,068.34 2025-07-01
113 MS_DRG Orbital Procedures With Cc/Mcc 2 1 — — $6,060.74 $6,060.74 $6,060.74 2025-07-01
5401 OTHER Dialysis 3 3 — — $266.25 $12,050.13 $5,998.88 2025-07-01
5594 OTHER Level 4 Nuclear Medicine And Related Services 44 13 — — $1,697.14 $10,217.14 $5,957.14 2025-07-01
9436 OTHER Inj Pegfilgrast Ex Bio 0.5mg 8 2 — — $3,594.58 $7,626.91 $5,610.74 2025-07-01
5183 OTHER Level 3 Vascular Procedures 22 5 — — $2,189.71 $8,956.68 $5,573.19 2025-07-01
7048 OTHER Alteplase Recombinant 10 3 — — $2,133.88 $8,744.26 $5,439.07 2025-07-01
9336 OTHER Inj Truxima 10 Mg 2 1 — — $5,433.24 $5,433.24 $5,433.24 2025-07-01
9329 OTHER Inj Mvasi 10 Mg 6 3 — — $4,853.74 $5,892.75 $5,373.24 2025-07-01
5593 OTHER Level 3 Nuclear Medicine And Related Services 60 13 — — $1,315.52 $9,392.86 $5,354.19 2025-07-01
7043 OTHER Infliximab Not Biosimil 10mg 8 3 — — $2,598.10 $7,841.66 $5,219.88 2025-07-01
626 MS_DRG Thyroid, Parathyroid And Thyroglossal Procedures With Cc 4 2 — — $5,179.92 $5,179.92 $5,179.92 2025-07-01
794 MS_DRG Neonate With Other Significant Problems 10 4 — — $2,784.32 $7,496.68 $5,140.50 2025-07-01
5302 OTHER Level 2 Upper Gi Procedures 16 5 — — $1,598.34 $8,660.56 $5,129.45 2025-07-01
440 MS_DRG Disorders Of Pancreas Except Malignancy Without Cc/Mcc 2 1 — — $5,067.25 $5,067.25 $5,067.25 2025-07-01
1847 OTHER Injection, Inflectra 4 2 — — $3,480.10 $6,652.64 $5,066.37 2025-07-01
9041 OTHER Epoetin Beta Esrd Use 14 5 — — $2,436.25 $7,362.55 $4,899.40 2025-07-01
795 MS_DRG Normal Newborn 18 8 — — $2,952.37 $6,801.96 $4,877.16 2025-07-01
72 MS_DRG Nonspecific Cerebrovascular Disorders Without Cc/Mcc 2 1 — — $4,868.13 $4,868.13 $4,868.13 2025-07-01
1489 OTHER Inj Vedolizumab IV 1 Mg 2 2 — — $372.17 $9,151.73 $4,761.95 2025-07-01
5443 OTHER Level 3 Nerve Injections 58 13 — — $975.03 $8,270.64 $4,622.84 2025-07-01
1712 OTHER Paclitaxel Protein Bound 2 1 — — $4,573.03 $4,573.03 $4,573.03 2025-07-01
5312 OTHER Level 2 Lower Gi Procedures 56 13 — — $1,239.60 $7,852.20 $4,545.90 2025-07-01
184 MS_DRG Major Chest Trauma With Cc 2 1 — — $4,437.12 $4,437.12 $4,437.12 2025-07-01
92 MS_DRG Other Disorders Of Nervous System With Cc 2 1 — — $4,364.08 $4,364.08 $4,364.08 2025-07-01
5112 OTHER Level 2 Musculoskeletal Procedures 28 6 — — $926.11 $7,616.61 $4,271.36 2025-07-01
9330 OTHER Inj., Kanjinti, 10 Mg 4 2 — — $2,322.61 $6,207.95 $4,265.28 2025-07-01
5573 OTHER Level 3 Imaging With Contrast 52 11 — — $464.87 $8,038.89 $4,251.88 2025-07-01
5182 OTHER Level 2 Vascular Procedures 4 2 — — $2,872.59 $5,494.12 $4,183.35 2025-07-01
493 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Cc 2 1 — — $4,146.01 $4,146.01 $4,146.01 2025-07-01
9476 OTHER Injection, Daratumumab 10 Mg 2 1 — — $4,058.11 $4,058.11 $4,058.11 2025-07-01
9096 OTHER Inj Retacrit Esrd On Dialysi 4 2 — — $2,789.80 $4,919.65 $3,854.72 2025-07-01
5071 OTHER Level 1 Excision/ Biopsy/ Incision And Drainage 8 6 — — $764.59 $19,186.71 $3,736.97 2025-07-01
5024 OTHER Level 4 Type A Ed Visits 74 17 — — $465.46 $6,989.02 $3,727.24 2025-07-01
915 MS_DRG Allergic Reactions With Mcc 2 1 — — $3,722.49 $3,722.49 $3,722.49 2025-07-01
9530 OTHER Plate Pheres Leukoredu Irrad 6 2 — — $859.98 $6,575.36 $3,717.67 2025-07-01
5791 OTHER Pulmonary Treatment 7 5 — — $58.80 $65,883.08 $3,646.71 2025-07-01
5572 OTHER Level 2 Imaging With Contrast 62 13 — — $385.04 $6,616.79 $3,500.91 2025-07-01
492 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc 2 1 — — $3,371.81 $3,371.81 $3,371.81 2025-07-01
5781 OTHER Resuscitation And Cardioversion 26 5 — — $1,012.78 $5,502.98 $3,257.88 2025-07-01
5072 OTHER Level 2 Excision/ Biopsy/ Incision And Drainage 20 12 — — $405.21 $8,288.00 $3,256.74 2025-07-01
5591 OTHER Level 1 Nuclear Medicine And Related Services 24 9 — — $462.24 $5,996.46 $3,229.35 2025-07-01
101 MS_DRG Seizures Without Mcc 2 1 — — $3,219.83 $3,219.83 $3,219.83 2025-07-01
833 MS_DRG Other Antepartum Diagnoses Without O.r. Procedures Without Cc/Mcc 4 2 — — $1,848.17 $4,484.28 $3,166.22 2025-07-01
9217 OTHER Leuprolide Acetate Suspnsion 10 4 — — $1,974.20 $4,257.71 $3,115.95 2025-07-01
5724 OTHER Level 4 Diagnostic Tests And Related Services 50 12 — — $994.25 $5,107.20 $3,050.72 2025-07-01
N905 OTHER Not Recognized By Opps 14 5 — — $156.19 $6,395.34 $2,957.55 2025-07-01
862 MS_DRG Postoperative And Post-traumatic Infections With Mcc 2 1 — — $2,952.91 $2,952.91 $2,952.91 2025-07-01
9357 OTHER Inj. Eptinezumab-jjmr 1 Mg 6 3 — — $1,587.01 $4,317.07 $2,952.04 2025-07-01
9031 OTHER Inj, Etelcalcetide, 0.1 Mg 2 1 — — $2,943.72 $2,943.72 $2,943.72 2025-07-01
7046 OTHER Doxorubicin Inj 10mg 2 1 — — $2,837.55 $2,837.55 $2,837.55 2025-07-01
793 MS_DRG Full Term Neonate With Major Problems 2 1 — — $2,836.83 $2,836.83 $2,836.83 2025-07-01
5311 OTHER Level 1 Lower Gi Procedures 64 13 — — $442.97 $4,917.64 $2,680.30 2025-07-01
5571 OTHER Level 1 Imaging With Contrast 66 16 — — $419.72 $4,926.44 $2,673.08 2025-07-01
5523 OTHER Level 3 Imaging Without Contrast 66 14 — — $303.50 $5,037.98 $2,670.74 2025-07-01
195 MS_DRG Simple Pneumonia And Pleurisy Without Cc/Mcc 2 1 — — $2,631.34 $2,631.34 $2,631.34 2025-07-01
47 MS_DRG Other Disorders Of The Eye Age >17 Without Cc 2 1 — — $2,583.94 $2,583.94 $2,583.94 2025-07-01
5673 OTHER Level 3 Pathology 22 7 — — $630.98 $4,431.40 $2,531.19 2025-07-01
0874 OTHER Synvisc Or Synvisc-one 3 2 — — $96.98 $2,867.39 $2,472.20 2025-07-01
9213 OTHER Inj. Pemetrexed Nos 10mg 4 2 — — $2,099.56 $2,719.92 $2,409.74 2025-07-01
5524 OTHER Level 4 Imaging Without Contrast 64 14 — — $544.72 $4,266.53 $2,405.62 2025-07-01
5592 OTHER Level 2 Nuclear Medicine And Related Services 30 10 — — $494.81 $4,278.48 $2,386.64 2025-07-01
5053 OTHER Level 3 Skin Procedures 2 1 — — $2,378.36 $2,378.36 $2,378.36 2025-07-01
5301 OTHER Level 1 Upper Gi Procedures 40 11 — — $829.57 $3,845.55 $2,337.56 2025-07-01
0902 OTHER Injection,onabotulinumtoxinA 16 4 — — $1,042.71 $3,614.74 $2,328.72 2025-07-01
9036 OTHER Injection, Renflexis 2 1 — — $2,305.28 $2,305.28 $2,305.28 2025-07-01
5025 OTHER Level 5 Type A Ed Visits 37 17 — — $820.06 $19,127.28 $2,243.44 2025-07-01
0800 OTHER Leuprolide Acetate 2 1 — — $2,111.42 $2,111.42 $2,111.42 2025-07-01
5442 OTHER Level 2 Nerve Injections 46 11 — — $501.78 $3,401.28 $1,951.53 2025-07-01
9522 OTHER Rbc Leukoreduced Irradiated 12 4 — — $635.76 $3,245.47 $1,940.62 2025-07-01
776 MS_DRG Postpartum And Post Abortion Diagnoses Without O.r. Procedures 2 1 — — $1,856.28 $1,856.28 $1,856.28 2025-07-01
5694 OTHER Level 4 Drug Administration 24 8 — — $189.25 $3,474.52 $1,831.88 2025-07-01
9286 OTHER Belatacept Injection 2 1 — — $1,626.79 $1,626.79 $1,626.79 2025-07-01
5073 OTHER Level 3 Excision/ Biopsy/ Incision And Drainage 2 1 — — $1,604.22 $1,604.22 $1,604.22 2025-07-01
5181 OTHER Level 1 Vascular Procedures 8 3 — — $885.34 $2,284.99 $1,585.16 2025-07-01
5241 OTHER Level 1 Blood Product Exchange And Related Services 20 6 — — $551.59 $2,452.40 $1,501.99 2025-07-01
5612 OTHER Level 2 Therapeutic Radiation Treatment Preparation 12 7 — — $482.27 $15,121.52 $1,421.11 2025-07-01
5371 OTHER Level 1 Urology And Related Services 2 1 — — $1,351.71 $1,351.71 $1,351.71 2025-07-01
5672 OTHER Level 2 Pathology 7 5 — — $29.52 $2,838.75 $1,304.03 2025-07-01
44 MS_DRG Acute Major Eye Infections 2 1 — — $1,235.14 $1,235.14 $1,235.14 2025-07-01
5023 OTHER Level 3 Type A Ed Visits 70 16 — — $295.38 $2,137.60 $1,216.49 2025-07-01
N907 OTHER Not Billable To Fi 3 3 — — $48.87 $1,216.48 $1,216.48 2025-07-01
9272 OTHER Inj, Denosumab 8 4 — — $660.72 $1,683.55 $1,172.13 2025-07-01
5771 OTHER Cardiac Rehabilitation 34 10 — — $160.71 $2,165.54 $1,163.12 2025-07-01
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